| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| SBR SERVICES LLC3 | 2300 WINDY RIDGE PKWY SE SUITE 695S ATLANTA, GA 30339 | SUN LIFE AND HEALTH INSURANCE COMPANY | $34K | $7K | $41K | 5.54% |
| TOMPKINS INSURANCE AGENCIES3 Filed as: TOMPKINS INSURANCE AGENCIES INC | 90 MAIN STREET BATAVIA, NY 14020 | SUN LIFE AND HEALTH INSURANCE COMPANY | $62K | $0 | $62K | 11.39% |
| JAMES R NELLIGAN & ASSOCIATES LLC3 Filed as: JAMES R. NELLIGAN & ASSOCIATES LLC | 1933 STATE ROUTE 35 SUITE 368 WALL, NJ 07719 | SUN LIFE AND HEALTH INSURANCE COMPANY | $0 | $32K | $32K | 5.77% |
| TOMPKINS INSURANCE AGENCIES3 Filed as: TOMPKINS INSURANCE AGENCIES INC | 90 MAIN STREET BATAVIA, NY 14020 | METROPOLITAN LIFE INSURANCE COMPANY | $20K | $0 | $20K | 10.00% |
| TOMPKINS INSURANCE AGENCIES3 Filed as: TOMPKINS INSURANCE AGENCIES INC | 90 MAIN STREET BATAVIA, NY 14020 | HARTFORD LIFE AND ACCIDENT | $16K | $336 | $16K | 10.21% |
| JAMES R NELLIGAN & ASSOCIATES LLC3 | 1933 STATE ROUTE 35 STE 368 WALL, NJ 07719 | HARTFORD LIFE AND ACCIDENT | $0 | $8K | $8K | 5.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| EXCELLUS BLUE CROSS BLUESHIELD EIN 15-0329043 ADMIN | Claims processing Service code 12 | — | $377K |
| DELTA DENTAL OF NEW YORK EIN 11-1980218 ADMIN | Claims processing Service code 12 | — | $41K |
| SUN LIFE AND HEALTH INSURANCE COMPA EIN 06-0893662 ADMIN | Claims processing Service code 12 | — | $13K |
Benefits declared on the Form 5500 main form (✓ = also has a Schedule A insurance contract; otherwise the benefit is funded out of plan assets or via a Schedule C TPA).
The plan reports several different headcounts depending on which form you read. Each one measures a different slice of the population.
| Active participants | 975 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 10 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 333 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 1,318 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Vision | METROPOLITAN LIFE INSURANCE COMPANY | 1,385 | $197K |
| Life insurance(2 contracts, 2 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 2,013 | $1.1M |
| Short-term disability(3 contracts, 2 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 2,013 | $1.2M |
| Long-term disability(2 contracts, 2 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 2,013 | $1.1M |
| Stop-loss / reinsurancereinsurance | SUN LIFE AND HEALTH INSURANCE COMPANY | 672 | $746K |
| Other(3 contracts, 3 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 2,013 | $1.3M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 2,013 | — |
Why the numbers differ. Form 5500 line 6 counts employees + retirees + beneficiaries; no dependents. Schedule A persons-covered counts everyone enrolled, including spouses and children, so it usually exceeds line 6 by 30-60% on a working-age workforce. The medical row is normally the broadest single line because it has the highest take-up; dental/vision/life often dip below it. Stop-loss / reinsurance contracts sometimes report the carrier's full underwriting pool rather than this filer's headcount; the row is shown for transparency but shouldn't be read as "people in this plan."
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.